Reasons for Jaw Bone Loss and Deterioration
The following are some of the most common causes for jaw bone deterioration and loss that may require a bone grafting procedure:
When an adult tooth is removed and not replaced, jaw bone deterioration may occur. Natural teeth are embedded in the jaw bone and stimulate the jaw bone through activities such as chewing and biting. When teeth are missing, the alveolar bone, or the portion of the jaw bone that anchors the teeth in the mouth, no longer receives the necessary stimulation and begins to break down, or resorb. The body no longer uses or “needs” the jaw bone, so it deteriorates and goes away.
The rate that the bone deteriorates, as well as the amount of bone loss that occurs, varies greatly among individuals. However, most bone loss occurs within the first few years following the extraction and can continue gradually throughout your life.
Periodontal diseases are ongoing infections and inflammation of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of the periodontal tissues: alveolar bone, periodontal ligaments, or gingiva. While there are many diseases that affect the tooth-supporting structures, plaque-induced inflammatory lesions make up a significant amount of periodontal issues and are generally divided into two categories: gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it usually precedes periodontitis.
Dental plaque is the primary cause of gingivitis in genetically-susceptible individuals. Plaque is a sticky colorless film, composed primarily of food particles and various types of bacteria, that adheres to your teeth at and below the gum line. Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria found in plaque produces toxins that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, the gums can separate from the teeth causing pockets (spaces) to form. If daily brushing and flossing is neglected, plaque can harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
Periodontitis can develop as bacteria adhere to the tooth’s surface, along with an overly aggressive immune response to these bacteria. If gingivitis progresses into periodontitis, the supporting gum tissue and bone that hold teeth in place deteriorates. The progressive loss of this bone, the alveolar bone, can lead to the loosening and subsequent loss of teeth.
Unanchored dentures are placed on top of the gum line, but they do not provide positive stimulation to the underlying alveolar bone. Over time the lack of stimulation and the force of the denture resting on the bone can cause the bone to resorb and deteriorate. Because this type of denture relies on the bone to hold them in place, people often experience loosening of their dentures and problems eating and speaking over time. Eventually, bone loss may become so severe that dentures cannot be held in place with strong adhesives, and a new set of dentures may be required. Proper denture care, repair, and refitting are essential to maintaining oral health.
Some dentures are supported by anchors, which can help preserve bone.
With bridgework, the teeth on either side of the appliance usually provide sufficient stimulation to the bone, but the portion of the bridge that spans the gap where the teeth are missing receives no direct stimulation. Bone loss can occur in this area.
Some common forms of tooth and jaw trauma include: teeth knocked out from injury or accident, jaw fractures, or teeth with a history of trauma that may die and lead to bone loss years after the initial trauma.
A bone grafting procedure could be necessary to treat the effects of bone deterioration, restoring function and promoting new bone growth in traumatized areas.
Misalignment issues can create a situation in the mouth where some teeth no longer have an opposing tooth structure. The unopposed tooth can over-erupt and contribute to a poor periodontal condition and deterioration of the associated bone.
Issues such as TMJ problems, normal wear-and-tear, and lack of treatment can also create abnormal physical forces that interfere with the teeth’s ability to function and chew properly. Over time, bone deterioration can occur.
Osteomyelitis is a type of bacterial infection in the bone and bone marrow of the jaw. This infection leads to inflammation, which can cause a reduction of blood supply to the bone. Treatment for osteomyelitis generally requires antibiotics and the removal of the affected bone. A bone graft procedure may be required to restore bone that is lost.
Benign facial tumors, though generally non-life threatening, may grow large and require the removal of a portion of the jaw. Malignant facial tumors can spread into the jaw, requiring the removal of the affected section of the jaw. In both cases, reconstructive bone grafting is often required to help restore normal function to the jaw. Grafting in patients with malignant tumors may be more challenging because treatment of the cancerous tumor can require removal of the surrounding soft tissues as well.
Some conditions or syndromes are characterized by missing portions of the teeth, facial bones, jaw or skull. Drs. Werner, Rubel, Strange or Madson may be able to perform a bone graft procedure to restore bone function and growth where it may be absent.
When molars are removed from the upper jaw, air pressure within the sinus cavity of the upper jaw (maxillary sinus) can cause resorption of the bone that formerly helped keep the teeth in place. As a result, the sinuses become enlarged (commonly referred to as pneumatization of the sinus).
This condition usually develops over several years and may result in insufficient bone for the placement of dental implants. Drs. Werner, Rubel, Strange or Madson can perform a procedure called a “sinus lift” that can treat enlarged sinuses to create more ideal bone for placement of dental implants.